CPH Mental & Behavioral Health

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CPH Liability Insurance

English Español

{{s}}

Coverage Type	Limit of Liability	Retention	Premium
Directors and Officers	{{Variables.limit \| currency:"$"}}	{{Variables.selectedretention\| currency:"$"}}	{{Variables.DOPremium \| currency:"$"}}
Employment Practices	{{Variables.limit \| currency:"$"}}	{{Variables.selectedretention\| currency:"$"}}	{{Variables.EPLIPremium \| currency:"$"}}
Fiduciary	{{Variables.limit \| currency:"$"}}	{{Variables.selectedretention \| currency:"$"}}	{{Variables.FLIPremium \| currency:"$"}}

{{discount.OnlineDescription}}		{{discount.OnlineDiscount}}%	{{ Variables.Discounts \| currency:"$ "}}
Premium Subtotal			{{ Variables.SubTotal \| currency:"$ "}}
Taxes	{{Variables.StateTaxDescription}}	{{Variables.StateTaxRate*100 \| number :2}}%	{{Variables.SubTotal*Variables.StateTaxRate \| number :2 \| currency:"$"}}
Taxes	{{Variables.CityTaxDescription}}	{{Variables.CityTaxRate*100 \| number :2}}%	{{Variables.SubTotal*Variables.CityTaxRate \| currency:"$"}}

Total			{{ Variables.Total \| currency:"$"}}

Save & Generate Proposal

Named Insured: {{Variables.orgName}}

{{Purchase.Valids.CardType.message}}

{{Purchase.Valids.NumberCard.message}}

{{Purchase.Valids.CardName.message}}

{{Lang == "es" ? 'Mes de Expiración' : 'Expires on Month'}}:

{{Purchase.Valids.Month.message}}

{{Lang == "es" ? 'Año de Expiración' : 'Expires on Year'}}:

{{Purchase.Valids.Year.message}}

{{Lang == "es" ? 'Código de Seguridad' : 'Security Code'}}: {{Lang == "es" ? '¿Qué es esto?' : 'What is this?'}}

{{Purchase.Valids.SecurityCode.message}}

{{Lang == "es" ? 'Dirección de Facturación' : 'Billing Address'}}

{{Lang == "es" ? 'Dirección' : 'Address'}}	{{Lang == "es" ? 'Ciudad' : 'City'}}	{{Lang == "es" ? 'Código Postal' : 'Zipcode'}} {{Lang == "es" ? 'Código Postal' : 'Postal Code'}}	{{Lang == "es" ? 'Estado' : 'State'}} {{Lang == "es" ? 'Provincia' : 'Province'}}
{{Variables.address}} {{Variables.address2}}	{{Variables.city}}	{{Variables.zipcode}}	{{Variables.state}} {{Variables.Province}}

{{Lang == "es" ? 'Dirección' : 'Address'}}		{{Lang == "es" ? 'Ciudad' : 'City'}}	{{Lang == "es" ? 'Código Postal' : 'Zipcode'}} {{Lang == "es" ? 'Código Postal' : 'Postal Code'}}	{{Lang == "es" ? 'Estado' : 'State'}} {{Lang == "es" ? 'Provincia' : 'Province'}}
{{Purchase.Valids.Address1.message}}		{{Purchase.Valids.City.message}}	{{Purchase.Valids.Zip.message}}	{{Purchase.Valids.State.message}}

Total: $ {{Variables.Total | number:2}} $ {{Variables.TotalPaid | number:2}} $ {{Variables.TotalPr | number:2}}

{{c.Title}}	Total
{{c.Value \| currency}}	{{SpecialPurchaseSummary.Total \| currency}}

Total: $ {{SpecialPurchaseSummary.Total | number:2}}

Message:{{Purchase.Result.Message}}

Named Insured: {{Variables.orgName}}

{{Purchase.Valids.CardType.message}}

{{Purchase.Valids.NumberCard.message}}

{{Lang == "es" ? 'Mes de Expiración' : 'Expires on Month'}}:

{{Purchase.Valids.Month.message}}

{{Lang == "es" ? 'Año de Expiración' : 'Expires on Year'}}:

{{Purchase.Valids.Year.message}}

CVC: {{Lang == "es" ? '¿Qué es esto?' : 'What is this?'}}

{{Purchase.Valids.SecurityCode.message}}

{{Purchase.Valids.CardName.message}}

{{Lang == "es" ? 'Dirección de Facturación' : 'Billing Address'}}

Your credit card was not able to be processed, please confirm your address below.

{{Lang == "es" ? 'Dirección' : 'Address'}}	{{Lang == "es" ? 'Ciudad' : 'City'}}	{{Lang == "es" ? 'Código Postal' : 'Zipcode'}}	{{Lang == "es" ? 'Estado' : 'State'}}
{{Variables.address}} {{Variables.address2}}	{{Variables.city}}	{{Variables.zipcode}}	{{Variables.state}}

{{Lang == "es" ? 'Dirección' : 'Address'}}		{{Lang == "es" ? 'Ciudad' : 'City'}}	{{Lang == "es" ? 'Código Postal' : 'Zipcode'}} {{Lang == "es" ? 'Código Postal' : 'Postal Code'}}	{{Lang == "es" ? 'Estado' : 'State'}} {{Lang == "es" ? 'Provincia' : 'Province'}}
{{Purchase.Valids.Address1.message}}		{{Purchase.Valids.City.message}}	{{Purchase.Valids.Zip.message}}	{{Purchase.Valids.State.message}}

Total: $ {{Variables.Total | number:2}} $ {{Variables.TotalPaid | number:2}} $ {{Variables.TotalPr | number:2}}

Message:{{Purchase.Result.Message}}

Named Insured: {{Client.ClientName}}

{{Lang == "es" ? 'Información de Pago con Pagos Mensuales' : 'Purchase Policy with Monthly Payment'}}

{{Purchase.Valids.CardType.message}}

{{Purchase.Valids.NumberCard.message}}

{{Purchase.Valids.CardName.message}}

{{Lang == "es" ? 'Mes de Expiración' : 'Expires on Month'}}:

{{Purchase.Valids.Month.message}}

{{Lang == "es" ? 'Año de Expiración' : 'Expires on Year'}}:

{{Purchase.Valids.Year.message}}

CVC: {{Lang == "es" ? '¿Qué es esto?' : 'What is this?'}}

{{Purchase.Valids.SecurityCode.message}}

{{Lang == "es" ? 'Dirección' : 'Address'}}	{{Lang == "es" ? 'Ciudad' : 'City'}}	{{Lang == "es" ? 'Código Postal' : 'Zipcode'}} {{Lang == "es" ? 'Código Postal' : 'Postal Code'}}	{{Lang == "es" ? 'Estado' : 'State'}} {{Lang == "es" ? 'Provincia' : 'Province'}}
{{Client.MailAddress1}} {{Client.MailAddress2}}	{{Client.MailCity}}	{{Client.MailZipCode}}	{{Client.MailState}} {{Variables.Province}}

{{Lang == "es" ? 'Dirección' : 'Address'}}		{{Lang == "es" ? 'Ciudad' : 'City'}}	{{Lang == "es" ? 'Código Postal' : 'Zipcode'}} {{Lang == "es" ? 'Código Postal' : 'Postal Code'}}	{{Lang == "es" ? 'Estado' : 'State'}} {{Lang == "es" ? 'Provincia' : 'Province'}}
{{Purchase.Valids.Address1.message}}		{{Purchase.Valids.City.message}}	{{Purchase.Valids.Zip.message}}	{{Purchase.Valids.State.message}}

Credit Information

Professional Liability Premium	{{FinProperties.TotalPremium \| currency}}
{{FinProperties.NumberOfInstallments}} Installments	{{FinProperties.InstallmentAmount \| currency}} / Month
APR	{{FinProperties.APR}}%
Finance Charge	{{FinProperties.FinanceCharge \| currency}}
Down Payment (15%)	{{FinProperties.DownPayment \| currency}}
Total with Financing Charge	{{FinProperties.TotalPremium + FinProperties.FinanceCharge \| currency}}

Down Payment: $ {{FinProperties.DownPayment | number:2}}

Submit the required down payment above.
You will receive an email from Input 1 (do-not-reply@pbsnetaccess.com) with the subject line "Your Premium Financing Agreement Quote is Ready for Your Approval".
Click the link in the email to view the financing agreement.
Accept the agreement and complete additional steps to set up your monthly payments to Input 1, the financing company.

If payment is not paid to the finance company, your policy will be cancelled for non-payment.

Message:{{Purchase.Result.Message}}

Named Insured: {{Client.ClientName}}

{{Purchase.Valids.CardType.message}}

{{Purchase.Valids.NumberCard.message}}

{{Purchase.Valids.CardName.message}}

{{Lang == "es" ? 'Mes de Expiración' : 'Expires on Month'}}:

{{Purchase.Valids.Month.message}}

{{Lang == "es" ? 'Año de Expiración' : 'Expires on Year'}}:

{{Purchase.Valids.Year.message}}

CVC: {{Lang == "es" ? '¿Qué es esto?' : 'What is this?'}}

{{Purchase.Valids.SecurityCode.message}}

{{Lang == "es" ? 'Dirección' : 'Address'}}	{{Lang == "es" ? 'Ciudad' : 'City'}}	{{Lang == "es" ? 'Código Postal' : 'Zipcode'}} {{Lang == "es" ? 'Código Postal' : 'Postal Code'}}	{{Lang == "es" ? 'Estado' : 'State'}} {{Lang == "es" ? 'Provincia' : 'Province'}}
{{Client.MailAddress1}} {{Client.MailAddress2}}	{{Client.MailCity}}	{{Client.MailZipCode}}	{{Client.MailState}} {{Variables.Province}}

{{Lang == "es" ? 'Dirección' : 'Address'}}		{{Lang == "es" ? 'Ciudad' : 'City'}}	{{Lang == "es" ? 'Código Postal' : 'Zipcode'}} {{Lang == "es" ? 'Código Postal' : 'Postal Code'}}	{{Lang == "es" ? 'Estado' : 'State'}} {{Lang == "es" ? 'Provincia' : 'Province'}}
{{Purchase.Valids.Address1.message}}		{{Purchase.Valids.City.message}}	{{Purchase.Valids.Zip.message}}	{{Purchase.Valids.State.message}}

Premium Summary

Annual Policy Premium	{{wfDefault.Invoice.Subtotal \| currency}}
Taxes 2022-1 FIGA Assessment Surcharge	{{wfDefault.Invoice.Taxes \| currency}}
Administrative Fee	{{wfDefault.Invoice.Fees \| currency}}

Total: $ {{wfDefault.Invoice.Total | number:2}}

Total: $ {{wfDefault.Invoice.TotalProrated | number:2}}

Message:{{Purchase.Result.Message}}

Premium 1	Premium 2	Premium 3
{{Variables.Premium01 \| currency:"$"}}	{{Variables.Premium02 \| currency:"$"}}	{{Variables.Premium03 \| currency:"$"}}

Premium Subtotal			{{ Variables.SubTotal \| currency:"$ "}}
Taxes	{{Variables.StateTaxDescription}}	{{Variables.StateTaxRate*100 \| number :2}}%	{{Variables.StateTaxTotal \| number :2 \| currency:"$"}}
Taxes	{{Variables.CityTaxDescription}}	{{Variables.CityTaxRate*100 \| number :2}}%	{{Variables.CityTaxTotal \| currency:"$"}}

Total			{{ Variables.Total \| currency:"$"}}

Submit

Uncheck the "Apply Payment in Nexsure box" if this is a partial payment or a split of two payment methods (credit card and check or 2 checks). For all PHLY Special event manual payments (American Express and Wires) uncheck the Apply Payment in Nexsure box).

TOTAL $	Payment Amount	Apply Payment in Nexsure
$ {{Variables.Total}} $ {{Variables.TotalPr}}		Yes No

TOTAL $

Payment Amount

Apply Payment in Nexsure

$ {{Variables.Total}}

$ {{Variables.TotalPr}}

Yes No

Policy Effective Date	E-mail Policy Documents to Client	Client E-mail
{{Variables.EffDate \| date}}	Yes No	{{Variables.Email}}

Submit

Premium Summary

Professional Liability Premium	{{OperationCoverages.PL.Premium \| currency}}
Additional Insured Premium	{{OperationCoverages.AdditionalInsured.Premium \| currency}}
Additional Occupation Premium	{{OperationCoverages.AdditionalOccupation.Premium \| currency}}
General Liability Premium	{{OperationCoverages.GL.Premium\|currency}}
Premium Subtotal	{{wfDefault.Invoice.Subtotal \| currency}}
Taxes 2022-1 FIGA Assessment Surcharge	{{wfDefault.Invoice.Taxes \| currency}}
Administrative Fee	{{wfDefault.Invoice.Fees \| currency}}

Total:
$ {{wfDefault.Invoice.Total | number:2}}

{{Lang == "es" ? 'Información de Pago con Cheque' : 'Check Payment Information'}}

Payment Amount	Apply Payment in Nexsure
	Yes No

If you prefer, you can include additional attachments to this invoice

Select a File {{GetOtherInsuranceFiles()}}

Policy Effective Date Change Effective Date	Send Email	Has binding conditions?
{{Variables.EffDate \| date}} {{Variables.EndorsementEffectiveDate \| date:'MM/dd/yyyy'}}	Yes No	Yes No

Submit Submit

Policy Effective Date	E-mail pending reason to client
{{Variables.EffDate \| date}}	Yes No

Submit Submit

Rates Table

Showing 6 of 10 levels. Click here for show all levels.

Coverage / Level	1	2	3	4	5	6	7	8	9	10
{{level.NewColumn}}	${{level.Level1}}	${{level.Level2}}	${{level.Level3}}	${{level.Level4}}	${{level.Level5}}	${{level.Level6}}	${{level.Level7}}	${{level.Level8}}	${{level.Level9}}	${{level.Level10}}
Please select your desired coverage level by clicking one of the following radio buttons.

Renewing Customers

Do you have a current Professional Liability Insurance Policy for Life Coaches with Philadelphia Insurance Company?

Yes No

Please enter your policy number or email address

Searching...

Your entry does match a record in our system:

Policy Number: {{userFound.PolicyNumber}}
Email address: {{userFound.Email}}
Current Retroactive date: {{userFound.RetroactiveDate}}
Current Effective date: {{userFound.EffectiveDate}}

Please proceed to complete remaining information in order to renew your policy.

We’re sorry, but your entry does not match a record in our system.
Please contact us at 800-875-1911 to retrieve your policy information.

Searching...

We’re sorry, but your entry does not match a record in our system.
Please contact us at 800-875-1911 to retrieve your policy information.

Submit

Payment Information

*Card Type: {{Purchase.Valids.CardType.message}}

*Card Number: {{Purchase.Valids.NumberCard.message}}

Shopping is always safe and secure

*Expires On:

{{Purchase.Valids.Year.message}} {{Purchase.Valids.Year.message}}

*Security Code: What is this? {{Purchase.Valids.SecurityCode.message}}

*Name on Card: {{Purchase.Valids.CardName.message}}

Gross Payment
Net Payment

Total: {{(!Variables.IsGrossPayment ? 0.80*Variables.TotalPremium + Variables.TotalTax + (Variables.Fee ? Variables.Fee : 0) : Variables.Total) | currency}}

Billing Address

Same as Insured:

{{Variables.orgName}}
{{Variables.address + ","}} {{Variables.address2}}
{{Variables.city + ","}} {{Variables.state}} {{Variables.zipcode}}

Street Address 1: {{Purchase.Valids.Address1.message}}*	Street Address 2:

City: {{Purchase.Valids.City.message}}*	State: {{Purchase.Valids.State.message}}*

Zip Code: {{Purchase.Valids.Zip.message}}*

Message:{{Purchase.Result.Message}}

Policy Effective Date	E-mail Policy Documents To Client
{{Variables.EffDate \| date}}	Yes No

Submit

Policy Effective Date	E-mail decline reason to client
{{Variables.EffDate \| date}}	Yes No

Submit Submit

In order to Bind Coverage you must generate a proposal
and accept the terms and conditions of the policy.

Save Application and Generate a Proposal

Submit Submit

Effective Date	Send Email
{{Variables.EffDate \| date}}	Yes No

Submit

Bind Coverage

Submit

Add another

{{row.MultiAnswerLabel}} Review errors Remove

Add another

PASO PREVIO PREV

GUARDAR APLICACIÓN SAVE APPLICATION

Quote Number: {{LogWF.QuoteNumber}}

Policy Number: {{LogWF.PolicyNumber}}

Policy Number: {{LogWF.PolicyNumberWithVersion}}

Thank you for choosing us.

Please select an address from the list below:

Street	City	Zipcode	State
{{a.ParsedAddressRange }} {{a.StreetName}} {{a.Suffix}}	{{a.City}}	{{a.Zip}}	{{a.State}}

Cancel

Please enter a valid suite, or unit and number and click "update".

Please enter a valid address.

Address 1

Address 2

City

State

Zipcode

Please select the best match below:

Street	Street 2	City	Zipcode	State
{{a.Line1 }}	{{a.Line2}}	{{a.City}}	{{a.PostalCode}}	{{a.StateProvince}}

Street	Street 2	City	Zipcode	State
{{ValidatingAddress.Line1 }}	{{ValidatingAddress.Line2}}	{{ValidatingAddress.City}}	{{ValidatingAddress.ZipCode}}	{{ValidatingAddress.StateProvince}}

Do not update, use address as entered:
{{EnteredAddress.Line1}} {{EnteredAddress.Line2}}, {{EnteredAddress.City}} {{EnteredAddress.StateProvince}} {{EnteredAddress.ZipCode}}

Do not update, use address as entered

Choose the Account from PATH to use for this Quote:
{{Variables.AccountMatchesFiltered}} Filtered result / {{Variables.AccountMatches}} results in total

	PHLY Risk Clearance	Street	City	State	Zipcode	Fein	AccountNumber	Phone
	{{a.Name}}	{{a.Address.Line1}} {{a.Address.Line2}}	{{a.Address.City}}	{{a.Address.StateProvince}}	{{a.Address.PostalCode}}	{{a.FEIN}}	{{a.AccountNumber}}	{{a.PhoneNumber}}

Create New Path Account

Coverage Type	Limit of Liability	Retention	Premium
Directors and Officers	{{Variables.limit \| currency:"$"}}	{{Variables.selectedretention\| currency:"$"}}	{{Variables.DOPremium \| currency:"$"}}
Employment Practices	{{Variables.limit \| currency:"$"}}	{{Variables.selectedretention\| currency:"$"}}	{{Variables.EPLIPremium \| currency:"$"}}
Fiduciary	{{Variables.limit \| currency:"$"}}	{{Variables.selectedretention \| currency:"$"}}	{{Variables.FLIPremium \| currency:"$"}}

{{discount.OnlineDescription}}		{{discount.OnlineDiscount}}%	{{ Variables.Discounts \| currency:"$ "}}
Premium Subtotal			{{ Variables.SubTotal \| currency:"$ "}}
Taxes	{{Variables.StateTaxDescription}}	{{Variables.StateTaxRate*100 \| number :2}}%	{{Variables.SubTotal*Variables.StateTaxRate \| number :2 \| currency:"$"}}
Taxes	{{Variables.CityTaxDescription}}	{{Variables.CityTaxRate*100 \| number :2}}%	{{Variables.SubTotal*Variables.CityTaxRate \| currency:"$"}}

Total			{{ Variables.Total \| currency:"$"}}

{{Insurance.Description}}

{{item.Title}}

{{Lang == "es" ? 'Información de Pago' : 'Payment Information'}}

{{Lang == "es" ? 'Dirección de Facturación' : 'Billing Address'}}

Total: $ {{Variables.Total | number:2}} $ {{Variables.TotalPaid | number:2}} $ {{Variables.TotalPr | number:2}}

{{c.Value | currency}}

{{SpecialPurchaseSummary.Total | currency}}

Total: $ {{SpecialPurchaseSummary.Total | number:2}}

{{Lang == "es" ? 'Importante' : 'Important'}}

{{Lang == "es" ? 'Información de Pago' : 'Payment Information'}}

{{Lang == "es" ? 'Dirección de Facturación' : 'Billing Address'}}

Total: $ {{Variables.Total | number:2}} $ {{Variables.TotalPaid | number:2}} $ {{Variables.TotalPr | number:2}}

{{Lang == "es" ? 'Términos y Condiciones' : 'Terms and Conditions'}}

{{Lang == "es" ? 'Información de Pago con Pagos Mensuales' : 'Purchase Policy with Monthly Payment'}}

{{Lang == "es" ? 'Dirección de Facturación' : 'Billing Address'}}

Total: $ {{wfDefault.Invoice.Total | number:2}}

Credit Information

Down Payment: $ {{FinProperties.DownPayment | number:2}}

{{Lang == "es" ? 'Términos y Condiciones' : 'Terms and Conditions'}}

{{Lang == "es" ? 'Información de Pago' : 'Payment Information'}}

{{Lang == "es" ? 'Dirección de Facturación' : 'Billing Address'}}

Total: $ {{wfDefault.Invoice.Total | number:2}}

Premium Summary

Total: $ {{wfDefault.Invoice.Total | number:2}}

Total: $ {{wfDefault.Invoice.TotalProrated | number:2}}

{{Lang == "es" ? 'Términos y Condiciones' : 'Terms and Conditions'}}

Check Payment Info

$ {{Variables.Total}}

$ {{Variables.TotalPr}}

Client Info

Premium Summary

Total:
$ {{wfDefault.Invoice.Total | number:2}}

{{Lang == "es" ? 'Información de Pago con Cheque' : 'Check Payment Information'}}

{{Lang == "es" ? 'Importante' : 'Important'}}

Payment Information

Billing Address

In order to Bind Coverage you must generate a proposal
and accept the terms and conditions of the policy.

{{SubmitConfirmation.Header}}

Thank you for choosing us.

{{Insurance.Description}}

{{item.Title}}

{{Lang == "es" ? 'Información de Pago' : 'Payment Information'}}

{{Lang == "es" ? 'Dirección de Facturación' : 'Billing Address'}}

Total: $ {{Variables.Total | number:2}} $ {{Variables.TotalPaid | number:2}} $ {{Variables.TotalPr | number:2}}

{{c.Value | currency}}

{{SpecialPurchaseSummary.Total | currency}}

Total: $ {{SpecialPurchaseSummary.Total | number:2}}

{{Lang == "es" ? 'Importante' : 'Important'}}

{{Lang == "es" ? 'Información de Pago' : 'Payment Information'}}

{{Lang == "es" ? 'Dirección de Facturación' : 'Billing Address'}}

Total: $ {{Variables.Total | number:2}} $ {{Variables.TotalPaid | number:2}} $ {{Variables.TotalPr | number:2}}

{{Lang == "es" ? 'Términos y Condiciones' : 'Terms and Conditions'}}

{{Lang == "es" ? 'Información de Pago con Pagos Mensuales' : 'Purchase Policy with Monthly Payment'}}

{{Lang == "es" ? 'Dirección de Facturación' : 'Billing Address'}}

Total: $ {{wfDefault.Invoice.Total | number:2}}

Credit Information

Down Payment: $ {{FinProperties.DownPayment | number:2}}

{{Lang == "es" ? 'Términos y Condiciones' : 'Terms and Conditions'}}

{{Lang == "es" ? 'Información de Pago' : 'Payment Information'}}

{{Lang == "es" ? 'Dirección de Facturación' : 'Billing Address'}}

Total: $ {{wfDefault.Invoice.Total | number:2}}

Premium Summary

Total: $ {{wfDefault.Invoice.Total | number:2}}

Total: $ {{wfDefault.Invoice.TotalProrated | number:2}}

{{Lang == "es" ? 'Términos y Condiciones' : 'Terms and Conditions'}}

Check Payment Info

$ {{Variables.Total}}

$ {{Variables.TotalPr}}

Client Info

Premium Summary

Total: $ {{wfDefault.Invoice.Total | number:2}}

{{Lang == "es" ? 'Información de Pago con Cheque' : 'Check Payment Information'}}

{{Lang == "es" ? 'Importante' : 'Important'}}

Payment Information

Billing Address

In order to Bind Coverage you must generate a proposal and accept the terms and conditions of the policy.

{{SubmitConfirmation.Header}}

Thank you for choosing us.

Total:
$ {{wfDefault.Invoice.Total | number:2}}

In order to Bind Coverage you must generate a proposal
and accept the terms and conditions of the policy.